ABSTRACT
In this chapter, the author argues that psychiatrists need to be more like histopathologists. This might at the very least take the form of much readier recourse to a second opinion. The management of gender identity disorders is one part of psychiatry where it seems to author that a high-quality second opinion is not just desirable, but rather is a necessity. The World Professional Association for Transgender Health, Inc. is clear that no one should be referred for gender reassignment surgery without a proper second opinion. Major difficulties are faced by small and sparsely populated countries – the Republic of Ireland or New Zealand, for example. The author suspects buying into the services of larger neighbours, either in toto or for second opinions and surgery, or perhaps teaming up with neighbouring small countries to make a joint service, might best serve countries of this sort.
